腹腔镜下保胆取石术结合依泽替米贝术前口服对胆囊结石患者血清皮质醇及促肾上腺皮质激素表达的影响

目的研究腹腔镜保胆取石术联合术前口服依泽替米贝治疗胆囊结石的疗效以及对血清中皮质醇(Cor)和促肾上腺皮质激素(ACTH)表达的影响。方法选择2017年6月至2019年6月本院收治的100例胆囊结石患者,采用随机数字表法分为观察组与对照组各50例。对照组患者给予腹腔镜下保胆取石术,观察组在对照组的基础上术前口服依泽替米贝药物治疗4周。比较两组患者胆囊结石个数、直径和治疗疗效,并检测术后不良反应发生情况,并通过手术前后Cor和ACTH水平的变化比较两组术后应激反应水平及并发症发生情况。结果治疗后观察组治疗总有效率高于对照组(P<0.05);两组患者结石直径和个数均显著下降(P<0.05),且观察组结石数量和直径均低于对照组(P<0.05);治疗前两组患者血清Cor、ACTH水平比较差异无统计学意义(P>0.05);治疗后两组患者的Cor、ACTH水平均升高(P<0.05);且观察组Cor、ACTH水平显著低于对照组(P<0.05),证明机体术后应激反应得到缓解;两组不良反应和并发症发生率比较差异均无统计学意义(P>0.05)。结论腔镜保胆取石术前口服依泽替米贝治疗胆囊结石可有效提高治愈率,降低术后血清Cor和ACTH水平,减少机体应激反应,降低患者术后感染的可能性,存在进一步探究的价值。

Effect of laparoscopic cholecystolithotomy combined with ezetimibe oral administration on serum Cor and ACTH expression in patients with cholecystolithiasis

【Objective】To study the effect of laparoscopic cholecystolithotomy combined with preoperative oral ezetimibe in the treatment of cholecystolithiasis and its effect on cortisol(Cor)and adrenocorticotropic hormone(ACTH)expression.【Methods】One hundred patients with gallstone admitted to our hospital between June 2017 and June 2019 were selected and randomly divided into observation group and control group with 50 patients in each group.Patients in the control group were given laparoscopic cholecystolithotomy,and patients in the observation group were given oral ezetimibe for 4 weeks before surgery on the basis of patients in the control group.The number and diameter of stones,therapeutic effect and immunological effect were compared between the two groups.【Results】Before treatment,there was no significant difference in the indicators between the two groups(P>0.05).After treatment,both groups were improved,the total effective rate of the observation group was significantly higher than that of the control group(P<0.05);the diameter and number of calculi in both groups were significantly decreased,while those in the observation group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05);Cor and ACTH in both groups were increased,and the rise rate in the observation group was significantly lower than that in the control group(P<0.05),which proved that Cor and ACTH were effective in relieving postoperative stress response.There was no statistically difference in the incidence of adverse reactions between the two groups(P>0.05).【Conclusion】Before endoscopic cholecystolithotomy,oral administration of ezetimibe can effectively improve the cure rate of cholecystolithiasis and reduce the postoperative immunosuppression of patients,which is of great significance for further exploration.